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Ultrasound Identifies Patients at Higher Stroke Risk

Transcranial doppler finds asymptomatic carotid stenosis patients who would benefit from surgery

WEDNESDAY, June 2 (HealthDay News) -- The detection of asymptomatic embolic signals using transcranial doppler (TCD) may help identify groups of patients with asymptomatic carotid stenosis who are at low or high risk of stroke, which could be useful in identifying those most likely to benefit from endarterectomy, according to a study published online May 28 in The Lancet Neurology to coincide with its presentation at the European Stroke Conference, held from May 25 to 28 in Barcelona, Spain.

In the Asymptomatic Carotid Emboli Study, Hugh S. Markus, of St. George's University of London, and colleagues evaluated patients with asymptomatic carotid stenosis of at least 70 percent using TCD. Patients were assessed at baseline and at six, 12 and 18 months, and followed for two years.

Of the 467 patients with evaluable recordings, the researchers found embolic signals present in 77 patients at baseline. In patients with embolic signals compared to those without, the hazard ratio for the risk of ipsilateral stroke and transient ischemic attack for up to two years was 2.54, with the hazard ratio for the risk of ipsilateral stroke alone at 5.57. The absolute annual risk of ipsilateral stroke or transient ischemic attack between baseline and two years was higher in patients with embolic signals than in those without (7.13 versus 3.04 percent). In addition, the absolute annual risk of ipsilateral stroke alone was higher in patients with embolic signals than in those without (3.62 versus 0.70 percent).

"Assessment of the presence of embolic signals on TCD might be useful in the selection of patients with asymptomatic carotid stenosis who are likely to benefit from endarterectomy," the authors write.

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